Uso del óxido nitroso como analgesia intraparto en pacientes de embarazo de alto riesgo en el Hospital Gineco-Obstétrico Enrique C. Sotomayor 2010-2011
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2012
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
El dolor de trabajo de parto es una sensación referida de las contracciones uterinas que se producen con el propósito de la expulsión del producto de la interacción compleja de varios factores. Existen varias opciones para aliviar este dolor (analgesia epidural, analgesia sistémica parenteral). Para todas existen opiniones a favor y en contra, por lo que se hace necesaria la exploración de nuevas alternativas. La administración de óxido nitroso puede realizarse con este propósito, debido a que se le atribuye un buen control del dolor y casi ningún efecto adverso o no deseado en gestantes y fetos, por lo que sería una opción de gran valor en embarazos de alto riesgo. En el hospital Gineco-Obstétrico “Enrique C. Sotomayor” se lo utiliza con poca frecuencia y se hacía necesario reportar la experiencia actual. Con el objetivo de evaluar la efectividad y seguridad analgésica intraparto de la mezcla de óxido nitroso-oxígeno al 50% para inhalación, en las embarazadas con trabajo de parto, se realizó un trabajo de tipo observacional descriptivo de diseño no experimental, longitudinal retrospectivo en el periodo 1 de febrero de 2010 a 31 de enero de 2011, en el que se incluyeron 107 pacientes seleccionadas de manera aleatoria, previo consentimiento informado. Para el análisis estadístico se emplearon frecuencias simples, porcentajes, promedio, desviación estándar. Los resultados mostraron que el 49,5% de las pacientes tenían entre 10 y 19 años (49,5%). El 29% tenían un embarazo de 38 semanas. En el 41,1% de las ocasiones se usó entre 51 y 100 PSI de óxido nitroso. El 36,4% de las pacientes reportó mareo. El 98.1% de los partos concluyeron por vía vaginal. El expulsivo duró en el 93,3% entre 1 a 15 minutos. El 60% no experimentó dolor luego del alumbramiento. El 61% experimentaron dolor pero el 39% fue leve durante la episiotomía. El 99,1% reportó algún nivel dolor, 51.4% moderado. El 92,5% tuvieron un líquido amniótico normal. El 62,6% clasificaron el uso como bueno.
The pain of labor is referred to a sense of uterine contractions that occur with the purpose of removal of the product of complex interaction of several factors. There are several options to ease the pain (epidural analgesia, systemic parenteral analgesia). For all there are opinions for and against, so it is necessary to explore new alternatives. The administration of nitrous oxide can be made for this purpose because it is given a good pain control and almost no unwanted side effects in pregnant women or fetuses, so it would be a choice of great value in high-risk pregnancies. In the Enrique C. Sotomayor Hospital, it is used infrequently and it was necessary to report the actual experience. In order to evaluate the effectiveness and safety of intrapartum analgesic mixture of nitrous oxide 50% oxygen inhalation in pregnant women in labor, work was carried out observational descriptive, not experimental, longitudinal retrospective period 1 January 2010 to December 31, 2011, which included 107 patients randomly selected, after informed consent. For statistical analysis we used simple frequencies, percentages, mean, standard deviation. The results showed that 49.5% of patients were between 10 and 19 (49.5%). 28% had a pregnancy of 40 weeks. In 41.1% of the time was used between 51 and 100 cubic inches of nitrous oxide. 36.4% of patients reported dizziness. 96% of deliveries completed vaginally. The expulsion took in 98.3% between 1 to 15 minutes. 60.7% experienced no pain after childbirth. 62.7% experienced mild pain during episiotomía.El 99.1% reported some level of pain. 92.5% had a normal amniotic fluid. 62.2% rated as good use (62.6%)
The pain of labor is referred to a sense of uterine contractions that occur with the purpose of removal of the product of complex interaction of several factors. There are several options to ease the pain (epidural analgesia, systemic parenteral analgesia). For all there are opinions for and against, so it is necessary to explore new alternatives. The administration of nitrous oxide can be made for this purpose because it is given a good pain control and almost no unwanted side effects in pregnant women or fetuses, so it would be a choice of great value in high-risk pregnancies. In the Enrique C. Sotomayor Hospital, it is used infrequently and it was necessary to report the actual experience. In order to evaluate the effectiveness and safety of intrapartum analgesic mixture of nitrous oxide 50% oxygen inhalation in pregnant women in labor, work was carried out observational descriptive, not experimental, longitudinal retrospective period 1 January 2010 to December 31, 2011, which included 107 patients randomly selected, after informed consent. For statistical analysis we used simple frequencies, percentages, mean, standard deviation. The results showed that 49.5% of patients were between 10 and 19 (49.5%). 28% had a pregnancy of 40 weeks. In 41.1% of the time was used between 51 and 100 cubic inches of nitrous oxide. 36.4% of patients reported dizziness. 96% of deliveries completed vaginally. The expulsion took in 98.3% between 1 to 15 minutes. 60.7% experienced no pain after childbirth. 62.7% experienced mild pain during episiotomía.El 99.1% reported some level of pain. 92.5% had a normal amniotic fluid. 62.2% rated as good use (62.6%)
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Oxido nitroso, Analgesia, Embarazo de alto riesgo, Hospital Gineco-Obstétrico Enrique Enrique C. Sotomayor, Cantón Guayaquil, Ecuador, Trabajo de parto, Epidemiología descriptiva, Estudios retrospectivos